Long-term Monitoring of Health Inequalities

This report presents a range of indicators selected in order to
monitor health inequalities over time.

With the exception of the Healthy Birthweight indicator,
significant health inequalities persist for each indicator covered
in the report.

Changes in the gap between the most and least deprived
areas in Scotland In a number of indicators, absolute
inequalities (the gap between the most and least deprived areas)
have narrowed over the longer term:

Premature Mortality (under 75 years) - the gap
has reduced by 15% from its peak in 2002, and is currently lower
than at the start of the time series in 1997. The gap has,
however, increased each year since 2013.

CHD
Mortality - the gap has halved from its widest point in
1998.

Alcohol-Related Admissions - the gap has reduced
by 32% since the start of the time series in 1996.

Low Birthweight – the gap has reduced by
30% since its peak in 2004. The bulk of this reduction had taken
place by 2008, with the gap fluctuating since then.

The gap for
Alcohol-Related Deaths is currently 28% lower than
at its peak in 2002. However, following a period where the gap
narrowed, it has been increasing since 2013, and is currently 13%
higher than at the start of the time series in 1997.

For the other indicators in the report, there has either been
little change or long term trends in the absolute gap are less
clear:

Healthy Life Expectancy

Heart Attack Admissions

Cancer Incidence

Cancer Mortality

Premature Mortality (aged 15-44 years)

Healthy Birthweight

Relative inequalities

The relative index of inequality (
RII)
indicates the extent to which health outcomes are worse in the most
deprived areas compared to the average throughout Scotland. It is
possible for absolute inequalities to improve, but relative
inequalities to worsen.

There are three
morbidity indicators for which the
RII can
reasonably be compared with one another: alcohol-related hospital
admissions; heart attack hospital admissions; and cancer
incidence.

Amongst these, relative inequalities in alcohol-related hospital
admissions have remained highest over the longer term. Relative
inequalities in heart attack admissions have increased since 2008,
and cancer incidence inequalities have remained relatively
stable.

Amongst the three comparable
mortality indicators (
CHD deaths,
alcohol-related deaths, and cancer deaths), relative inequalities
in
CHD mortality
have increased over the long term. The relative inequalities in
alcohol-related deaths have shown more year to year fluctuation
over the same period, but ultimately the
RII for
2016 (1.89) is very similar to at the start of time series in 1997
(1.88).

The
RII for
cancer mortality has increased slightly over the longer term.
However, inequalities remain wider in alcohol-related deaths and
coronary heart disease deaths.

Of the other indicators in the report, the two indicators
relating to premature mortality (under 75 and aged 15-44) have both
shown increases in
RII over
time.